A Comparative Multi-Level Analysis of Health Program Effects on Individual Use of Reproductive and Sexual Health Services

Abstract:
This study assesses the influence of health resource inputs, in the form of facilities, commodities and knowledge, on the likelihood of individual use of family and other reproductive health services in four developing countries. The data analyzed are drawn from multi-stage cluster sample surveys in Paraguay, Uganda, Tanzania, and northern India, which selected health facilities and female populations for interviews. Although previous studies are equivocal about such effects, this study finds health-system factors, such as distance, types of services provided, and exposure to health messages, to influence significantly individual consumption of services for contraception, maternity care, and sexual health services, net of demand factors. A strong distance decay effect is observed on women's use of maternity services. The study also finds, however, that in these low-income settings women's consumption of health services is primarily influenced by household and individual socioeconomic status.

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